Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P84

Laryngology

P84
Otolaryngology-Head and Neck Surgery 163(1S)
Presentation schedule is subject to change. The Official Program Abstracts supplement does not reflect changes made after August 10, 2020.
cough as an alternative to neuromodulators. Preliminary studkeratosis without atypia group and the atypia group. The lonies have demonstrated efficacy in subjective complaints as
gest time period from initial biopsy to malignancy in the keratowell as cough survey index scores. The number of blocks and
sis without atypia group was 139 months. The incidence of
longitudinal follow-up have not been evaluated fully.
cancer in the keratosis without atypia group was 9.8%.
Methods: A retrospective review was conducted of 35
Conclusions: We found no differences in the malignant
patients who underwent serial in-office superior laryngeal
transformation rates or time until development of cancer
nerve blocks with longitudinal follow-up for up to 1 to 2
between the keratosis without atypia and all atypia severity
years.
groups. Keratosis without atypia should be followed in a simiResults: Ninety percent of patients had longitudinal followlar fashion to keratosis with atypia and carcinoma in situ.
up of between 12 and 36 months after last injection without
need for neuromodulators and/or further intervention in the
Long-term Outcomes With Gore-Tex
form of repeat superior laryngeal nerve blocks.
and Montgomery Implant Medialization
Conclusions: Longitudinal follow-up of patients who underLaryngoplasty: A 19-Year Experience
went
superior laryngeal nerve blocks demonstrates efficacy
Sungjin A. Song, MD (Presenter); Alena Santeerapharp, MD;
over
12
to 36 months after last injection, without further
Kanittha Choksawad, MD; Ramon A. Franco, MD
need for intervention or neuromodulators. This suggests
Objectives: Gore-Tex and the Montgomery implants have
that superior laryngeal nerve blocks are effective long-term
both been increasingly used in medialization laryngoplasty to
treatment options for patients with chronic neurogenic
treat glottal incompetence. Our objective was to understand
cough.
the long-term effectiveness of the Gore-Tex and Montgomery
implants and their associated complications.
Mitomycin for Subglottic Stenosis:
Methods: Patients who underwent medialization laryngoA Systematic Review and Meta-analysis
plasty at a quaternary care specialty hospital from 2001 to 2019
Mark C. Spaw, MD (Presenter); Matthew R. Naunheim, MD;
were identified. Patients who had concomitant adduction aryteSachie Shishido; Sungjin A. Song, MD
nopexy and/or cricothyroid subluxation at the time of surgery
Objectives: To determine the effectiveness of mitomycin C
were excluded. Patient demographics, quality-of-life measures,
(MMC) in the endoscopic treatment of adult subglottic stenoprocedures, complications, and revision surgeries were recorded.
sis with regard to the frequency of dilation, time to subsequent
Results: We identified 222 thyroplasty type 1 patients, of
procedure, and respiratory function.
whom 86 (mean age 59.21 years [range, 22-84], 55.8%
Methods: This is a systematic review focused on subglottic
male) met inclusion criteria. Mean time from diagnosis to
stenosis treated endoscopically with MMC in adults. Studies
surgery was 51.8 months (range, 1-465). Fifty-nine patients
that did not specify subglottic stenosis or patients who underhad unilateral thyroplasty, whereas 27 had bilateral thyrowent prior open treatment before the study were excluded. We
plasty (all Gore-Tex). There was a statistically significant
searched PubMed/MEDLINE, Embase, and Web of Science
improvement in the mean voice-related quality of life from
Core Collection. Search terms included "mitomycin," "sub36.3 (range, 15-50) preoperatively to 21 (range, 10-46)
glottic stenosis," "laryngotracheal stenosis," and "adult."
postoperatively (P < .01). A significant increase was seen in
Results: A total of 204 studies were screened; 75 were
the mean maximum phonation time (MPT) from 8.52 secreviewed and 14 studies were included. A total of 367 patients
onds (range, 2-20) to 12.47 seconds (range, 3-25) after type
treated with MMC underwent a total of 535 procedures. In
1 thyroplasty (P < .01). Complications included 3 with postpatients treated with MMC, 38.8% required a single proceoperative dyspnea requiring revision surgery within
dure whereas 61.3% required multiple procedures. The mean
48 hours and 5 cases of implant extrusion. All 8 cases were
interval to subsequent surgery (days) for patients treated with
implanted with Gore-Tex and had revision surgery. There
MMC was 404.4 ± 408.5 and without MMC was 381.1 ±
were 12 cases that had touch-up procedures on average of
411.9 (P = .431). The number of procedures per patient for
50 months after initial medialization.
those treated with MMC was 2.7 ± 2.25. In patients treated
Conclusions: Medialization laryngoplasty with Gore-Tex
with MCC, the mean preoperative airway resistance was 1.005
provides long-term improvement in MPT and voice-related
± 0.405 kPa/(L/s) and postoperative was 0.53 ± 0.09 kPa/(L/s)
quality-of-life measures in patients with glottic incompetence.
(P = .001).
The revision and extrusion rates were higher than previously
Conclusions: When comparing patients who were and
reported in the literature.
were not treated with MMC, there was no statistically significant difference in the interval to subsequent operations.
Longitudinal Follow-up for Patients With
In patients treated with MMC, there was a significant reducChronic Neurogenic Cough Treated With
tion in postoperative airway resistance. Overall, studies
Superior Laryngeal Nerve Block
evaluating endoscopic utilization of MMC in the treatment
Vaninder Dhillon, MD (Presenter)
of subglottic stenosis were heterogeneous. Further research
is needed focusing on prospective studies comparing MMC
Objectives: Superior laryngeal nerve block has been shown
with placebo.
to be effective in treating patients with chronic neurogenic

Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts

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